Endocrine Pathology - Hyper & Hypopituitarism Flashcards
FLATPeG
F - FSH L -LH A - ACTH T - TSH P - PRL e - endorphins G - GH
Posterior pituitary
- pituicytes (modified glial cells)
- oxytocin and ADH produced in hypothalamus -> stored in post. pituitary
most common cause of hyperpituitarism
pituitary adenoma
-micro <1cm; macro >1cm
mass effect***
- bitemporal hemaniopsia (compress optic chiasm)
2. Pituitary Apoplexy
pituitary adenomas
- MONOMORPHIC -> all look the same
- lack reticulin in stroma
Lactotroph adenomas (most common)
- PRL secretion
- PSOMMOMA bodies (Calcification)
-treat w/ Bromocryptine
Somatotroph adenomas
- GH secretion
- Gigantism (BEFORE closure)
- Acromegaly (AFTER closure)
- diagnosis: failure to suppress GH release w/ oral glucose
- treat: somatostatin, pegvisomant
Corticotroph adenomas
- ACTH secretion
- Periodic acid-schiff (PAS) +
- Cushing Disease -> excess ACTH and cortisol
- Nelson syndrome -> destructive pituitary adenoma w/ adrenal removal (loss of cortisol suppression) -> hyperpigmentation
-diagnosis w/ dexamethasone suppression test***
Hypopituitarism
- Ratchke cleft cysts
- pituitary apoplexy
- SHEEHAN syndrome -> ischemic necrosis
- Craniopharyngioma (hypothalamus)
- EMPTY SELLA syndrome
- PIT-1 mutations
most common cause of SIADH?
small cell carcinoma of the lung
what mutations are seen with GH (somatotroph) adenomas?
GNAS and AIP
what mutations are seen with GH and PRL adenomas?
PRKAR1A
what mutations are seen with aggressive adenomas?
cyclin D1 and RB
what mutations are seen with pituitary carincoma?
HRAS
what mutations are seen with GH, PRL, ACTH adenomas?
MEN1**
